Download A four year old girl has had a swollen, painless left knee joint for

A four year old girl has had a swollen, painless left knee joint for eight weeks. In the last ten
days her left ankle has become swollen. It is uncomfortable after she has been sitting for
twenty minutes. Examination of her eyes shows an irregular pupil on the right side.
What is the most appropriate first step in the management of this patient?
A.
A painful heel due to enthesiopathy is a common associated condition
B.
Her pupillary abnormality is likely to be due to a dislocated lens
C.
Synovectomy leads to improved joint function over the short and medium term
D.
The HLA B27 gene is a strong marker for this condition
E.
This child is likely to be rheumatoid factor negative
A 19 year old motorcyclist is brought to the Emergency Department following an RTA. He is
complaining of difficulty moving his left arm. Clinical examination suggests the latissimus
dorsi, subscapularis, pectoralis major and pectoralis minor are functioning but infraspinatus
is not functioning.
Which part of the brachial plexus is most likely to have been injured?
A.
The lateral cord
B.
The medial cord
C.
The middle trunk
D.
The posterior cord
E.
The upper trunk
A 35 year old man has a combined ACL rupture and posterolateral instability. There is a
bony varus knee deformity with lateral thrust in the stance phase of gait.
What is the most appropriate treatment for this patient?
A.
ACL reconstruction alone
B.
Distal femoral osteotomy
C.
Reconstruction of the posterolateral corner alone
D.
Simultaneous reconstruction of the ACL and the posterolateral corner
E.
Valgus osteotomy and ligament reconstruction simultaneously
A 25 year old man had an acute dislocation of his shoulder, which was reduced. During the
follow-up visit he was found to have wasting of the deltoid and the infraspinatus muscles.
Injury to which one of the following neural structure accounts for this finding?
A.
Axillary nerve
B.
Lateral cord of the brachial plexus
C.
Posterior cord of the brachial plexus
D.
Suprascapular nerve
E.
Upper trunk of the brachial plexus
A 20 year old girl has had low back pain for the last six months. She has no fever or
constitutional symptoms. Radiographs of her thoracic spine show coarse striations of the
vertical trabeculae of the 12th thoracic vertebra. Her ESR is normal.
What is the most likely diagnosis?
A.
Bone cyst
B.
Fibrous dysplasia
C.
Haemangioma
D.
Non-ossifying fibroma
E.
Osteoblastoma